Consumers must be well-informed about the newer attributes of health insurance during this pandemic
With Covid-19 still a health threat across the globe, people are looking for health insurance to safeguard themselves and their families. An informed health insurance policy can help individuals avail maximum benefits from the policy. One should be informed about the needs and requirements as per the medical history and requirements of the family.
Covid cover is now a prerequisite in any health insurance policy and information about Covid coverage is equally significant. Covid-19 cases witnessed a surge in the months of April-May across the country, and hence health insurance claims have also been on the rise. Recently, health insurance companies have increased their premium in the beginning of FY 21-22; wherein, most companies increased their premium by 10 per cent. While non-revision of the premium prices in the last few years have been one of the main reasons for premium price increase; huge claim settlement amount due to Covid, has also been another reason for the same.
Apart from premium price increase, health insurance companies introduced many additions and subtractions in the policies, majorly catering to the Covid-19 crisis. Consumers should be well informed about the newer attributes, so that they can make optimum use of the health insurance policies during this Covid pandemic.
Waiting Period: While the waiting period for general health insurance policies ranges from 15-30 days (for people without pre-existing diseases); Covid survivors will need to wait for close to three months before they buy a health insurance policy. Some insurers like Manipal Cigna, HDFC ERGO, ICICI Lombard and Max Bupa, have introduced a ‘cooling-off’ or waiting period for three months, for people who suffered from Covid-19. A Covid negative test, for a Covid survivor is a must now; and the waiting period starts from the date of the Covid negative test result date. This is primarily to mitigate the risk of post covid after effects.
Home care reimbursement: In case, the insured is suffering from Covid-19, and does not get admission in hospitals due to various reasons like unavailability of bed, lack of facilities in the hospital or extreme critical condition where there is no possibility of taking the patient to the hospital; the patient can avail domiciliary hospitalisation. It is now a part of the health insurance policy. Some insurance companies offer it as an in-built feature whereas some provide it as an add on cover. Hence, if the consumer feels the need for home care treatment, he or she should take a note whether the policy he is purchasing provides Domiciliary Hospitalisation as a feature.
Most of the Corona Kavach or Corona Rakshak policies are providing the feature of Domiciliary Hospitalisation. However, one should check with their respective insurers and inform them before opting for home care Covid treatment. This helps the insurer become informed well in advance and can help the policy holder with the requisite documentation procedures.
Covid claim settlement: The claims for Covid-19 are now treated under the general health insurance claim and with the insurance regulator’s guidelines, TAT (turnaround time) for Covid claim settlement has been reduced by most insurers.
For hospitalisation cover, the policy holder should submit duly filled and signed claim form, KYC (Identity proof with Address), medical practitioner’s prescription advising admission, original bills with itemised break-up, payment receipts, discharge summary. It should also include complete medical history of the patient, insured person’s test reports from authorized diagnostic centres for Covid, NEFT Details, cancelled cheque, legal heir/succession certificate. In case of Domiciliary Hospitalisation; certificate from medical practitioner, advising treatment at home, discharge certificate from medical practitioner specifying date of start and completion of home care treatment is required.
In case of cashless claims which are settled at the hospital by the insurer, one should make sure that all queries raised by insurer/TPA are resolved by the hospital authority on priority.
Cashless Hospitals: A lot of insurance companies have tied up with network hospitals for cashless treatments. These hospitals have associated with insurance companies so that they can help one avail the benefits of cashless treatment during medical emergencies. Of late, this has become a significant parameter for choosing health insurance plans. For new policy holders or even for people who are looking at renewing their existing health plans, this parameter ensures that policyholders can look at immediate hospitalisation without any hassle, in case of an emergency.
The author is Co- Founder, RenewBuy.
DISCLAIMER: Views expressed are the author’s own, and Outlook Money does not necessarily subscribe to them. Outlook Money shall not be responsible for any damage caused to any person/organisation directly or indirectly.